Klinični oddelek za abdominalno kirurgijo, Kirurška klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija
Background. Pancreatic injuries in children are rare and are most often caused by mechanisms of blunt injury to the abdomen. Injury to the pancreas in children may be difficult to diagnose and treat.
Patients and methods. From January 2005 to December 2011, 9 children with pancreatic injuries were treated in the Paediatric Surgical Unit, University Medical Centre Ljubljana.
Results. There were 7 (77.8%) boys and 2 (22.2%) girls, aged from 6 years to 15 years (mean, 9.6 years). The mode of injury was: 4 (44.5%), punch to the abdomen by a peer, 2 (22.2%) cycle handlebar during a fall from a bicycle, 1(11.1%) fall from a horse, 1 (11.1%), fall from a motorcycle, 1 (11.1%), explosive penetrating injury to the abdomen.
Serum amylase and lipase were raised in all nine children. All the injured children underwent preliminary abdominal ultrasonography (USG). Five (55.6%) children underwent computed tomography (CT) scan, one (11.1%) child underwent a laparotomy due to an isolated pancreatic injury. On exploration, the child was found to have a contusion of the duodenum and pancreas. A haematoma was evacuated and the peritoneal cavity drained. Five (55.5%) children were operated for concomitant injuries. Three (33.3%) children were managed conservatively.
Conclusion. Non-operative management of pancreatic injuries is effective and safe in haemodynamically stable patients with no other indication for surgery.
Key words: pancreas, injury, child, treatment.